The MedPAC Blog

Each year during its update process (read this post for more on that), the Commission examines Medicare’s payments to hospitals for inpatient and outpatient care. As part of this analysis, MedPAC compares Medicare’s payments to hospitals’ costs to determine a Medicare “margin.” For several years, these margins have been negative, indicating that on average, Medicare’s payments are less than hospitals’ costs.
Some would argue that negative margins are an indication that Medicare needs to increase its payments to cover hospital costs. A different way to think about the issue is to ask whether hospitals’ costs have to be as high as they are and whether hospitals have the ability to control costs. Said differently, we wondered, “Are hospital costs immutable?”

At our November meeting, we had a session on beneficiary access to hospital services, which was the first part of MedPAC's yearly work on payment updates.
Here’s an explainer on why we do this work and what it entails...

At MedPAC’s October public meeting, the Commission discussed patterns of potentially inappropriate opioid use in Medicare’s prescription drug benefit, Part D. In 2011, 10 million beneficiaries, or about 32 percent of Part D enrollees filled at least one prescription for an opioid. The share of Part D enrollees who use opioids in varies considerably across states.

At MedPAC’s October public meeting, the Commission had a session that focused on how Medicare can get the payment rates right in its fee schedule for physicians, nurses, and allied health professionals.

If you missed the Commission meeting last week, you might have missed this piece of analysis.
In 2012, about 28% of all Medicare beneficiaries (who have Part A and Part B) were enrolled in private Medicare Advantage (MA) plans. Recently, there has been a widely reported claim in the policy community that half of all new Medicare beneficiaries are now joining MA. The story sort of works like this: in 2012, the total number of beneficiaries in Medicare grew by two million, while the number of beneficiaries in MA grew by 1 million. These facts are true, but despite how it might sound, this does not mean that half of all new beneficiaries chose MA.

This week at our September public meeting, the Commission will discuss the latest information available on Accountable Care Organizations (ACOs) in Medicare. In the meantime, here is some background about the Commission’s work on the issue to date.

Next week, MedPAC kicks off its 2014-2015 year of public meetings. The agenda will be posted later today, but if you are new to the Commission, or a casual follower, you might wonder how the process works. Here’s a quick primer on MedPAC meetings.